Early life stress-induced miR-708-5p affects bipolar disorder-associated phenotypes through neuronatin downregulation

Mood-disorders (MDs) are caused by a complex interplay of genetic and environmental (GxE) risk factors. However, the molecular pathways engaged by GxE risk factors to trigger specific MD-associated endophenotypes are still poorly understood. Here, by using unbiased small RNA sequencing in peripheral blood mononuclear cells (PBMCs), we identified the BD-associated miR-708-5p as one of the most strongly upregulated microRNAs in peripheral blood of both healthy human subjects with a high genetic or environmental (early life stress) predisposition to develop MDs. miR-708 is also upregulated in the hippocampus of rats which underwent juvenile social isolation, a rodent model of early life stress. Furthermore, ectopic overexpression of miR-708-5p in the hippocampus of adult male mice is sufficient to elicit MD-associated behavioural endophenotypes, demonstrating a causal role for elevated miR-708-5p levels in MD development. We further show that miR-708-5p directly targets Neuronatin (Nnat), an endoplasmic reticulum (ER) resident protein involved in calcium homeostasis. Consequently, restoring Nnat expression in the hippocampus of miR-708-5p overexpressing mice rescues miR-708-5p dependent behavioural phenotypes. Finally, miR-708-5p is strongly upregulated in PBMCs derived from patients diagnosed with MD, in particular BD males. Peripheral expression of miR-708-5p, in conjunction with the previously identified miR-499-5p, allows to differentiate male BD patients from patients suffering from major depressive disorder (MDD) and healthy controls. In summary, we describe a functional role for the miR-708-5p/Nnat pathway in MD etiology and identify miR-708-5p as a potential biomarker for the differential diagnosis of MDs.